April Todd to Lead CAQH CORE and Explorations

CAQH announced that April Todd has joined the organization as Senior Vice President of CAQH CORE and Explorations. In this role, she will be responsible for leading industry efforts to develop and adopt operating rules for electronic transactions across the continuum of fee-for-service (FFS) to value-based payment (VBP). She will also direct CAQH Explorations research functions, including the CAQH Index.

“If we can increase the level of automation across healthcare business processes, everyone will benefit,” said Robin Thomashauer, President of CAQH. “We’re thrilled to have April leading this effort.”

Prior to joining CAQH, April led data, analytic, strategic and product development functions focused on value-based care for Avalere Health, an Inovalon Company. Previously, she established the Minnesota health insurance exchange (MNsure), served as Minnesota’s State Health Economist, and held leadership roles at UnitedHealth Group.

A multi-stakeholder collaboration of public and private entities across the healthcare industry, CAQH CORE drives the creation and adoption of healthcare operating rules that support standards, accelerate interoperability, and align administrative and clinical activities among providers, payers and consumers. CORE Certification is the gold standard for demonstrating market adoption and adherence to operating rules to exchange data efficiently and effectively.

“Inefficiencies and outdated business practices burden payers and providers, and hinder the delivery of high-value care to patients,” April Todd said. “By bringing all stakeholders together, CAQH CORE and Explorations are driving and measuring major changes in the industry. I am proud to be leading these efforts.”

About CAQH CORE and Explorations

CAQH CORE is a nonprofit collaboration of over 130 organizations, including health plans, providers, vendors, state and federal government entities, standards development organizations, and other stakeholders across the industry. Through this collaboration, CAQH CORE helps stakeholders uniformly adopt electronic transactions and exchange data efficiently and effectively. Since 2005, CAQH CORE has developed and issued four phases of operating rules that support standards, accelerate interoperability and align fee-for-service administrative activities among providers, payers and consumers. The CAQH CORE scope has since expanded to include information sharing needs for value-based payment. www.caqh.org/core

CAQH Explorations measures the impact and opportunity associated with streamlining healthcare business processes through various research initiatives, including the CAQH Index. The CAQH Index helps the industry optimize operations by tracking trends in adoption rates and cost savings associated with the shift from manual to electronic transactions. www.caqh.org/explorations